- HCA Healthcare (Austin, TX)
- …exercise sound judgment. **Qualifications you will need:** + Minimum 1-2 years' experience in Medical Insurance Claims Follow-up for a facility, medical ... issues and thereby affect payment and/or bringing them to resolution . **What you will do in this role:** +...perform pertinent follow-up. + Reconcile balances and payments between insurance companies and client's computer systems. + Medical… more
- HCA Healthcare (Austin, TX)
- …want to join an organization that invests in you as a Workers Compensation Claims Resolution Specialist? At Parallon, you come first. HCA Healthcare has ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...difference. We are looking for a dedicated Workers Compensation Claims Resolution Specialist like you to be… more
- Sedgwick (Austin, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Advisor, Medical Malpractice (Professional Liability) **PRIMARY ... PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution...required. **Skills & Knowledge** + In-depth knowledge of appropriate medical malpractice insurance principles and laws for… more
- Sedgwick (Austin, TX)
- …line-of-business + Extensive knowledge and comprehension of insurance coverage + Claims expertise in medical malpractice, errors and omissions, directors and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Advisor, Professional Liability (A&E, D&O,...and omissions, architects and engineers, and directors and offers claims ; to provide resolution of highly complex… more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Life Science Claims Specialist (REMOTE US) **PRIMARY PURPOSE** **:** ... to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company standards, industry best practices and… more
- Sedgwick (Austin, TX)
- …limits. + Manages the litigation process; ensures timely and cost effective claims resolution . + Coordinates vendor referrals for additional investigation and/or ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance General Liability Claims Examiner | Hybrid...through well-developed action plans to an appropriate and timely resolution . + Assesses liability and resolves claims … more
- Sedgwick (Austin, TX)
- …limits. + Manages the litigation process; ensures timely and cost effective claims resolution . + Coordinates vendor referrals for additional investigation and/or ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Texas Non-Subscriber Claims Examiner - Plano,...through well-developed action plans to an appropriate and timely resolution . + Assesses liability and resolves claims … more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Surety Claims Advisor **PRIMARY PURPOSE** **:** To analyze complex or ... technically difficult contract surety bond claims ; to provide resolution of highly complex...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Bodily Injury Claims Examiner | Remote | Dedicated Client | Complex ... Claims & Litigation Experience Required **Must have experience with...through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the… more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation (Remote - Med Only or Minor ... agency. + Develops and coordinates low level workers compensation claims ' action plans to resolution , return-to-work efforts,... coding is correct. + May process low-level lifetime medical and/or defined period medical claims… more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and...and to move the file towards prompt and appropriate resolution . + Identifies and pursues subrogation and risk transfer… more
- Centene Corporation (Austin, TX)
- …inbound and outbound calls with members and provider offices to provide resolution to claims (ie: additional information requests and medication determination ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Travelers Insurance Company (Austin, TX)
- …and/or complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims , as well as General Liability Coverage B claims and E&O ... severe/complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims , as well as General Liability Coverage B claims and E&O … more
- Travelers Insurance Company (Austin, TX)
- …claimants or their legal representatives. + Recognize and implement alternate means of resolution . + Manages litigated claims . Develop litigation plan with staff ... evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle… more
- Cardinal Health (Austin, TX)
- …appeals, providing documentation and support as needed. + Reviews and analyzes insurance claims for accuracy and completeness before submission. + Investigates ... insurance verification or related role preferred. + Advanced knowledge of medical insurance terminology, policies, and procedures. + Skilled in using EHR… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …The local "ecosystem approach" creates a unified focus among account management, medical , patient access and market access to engage local healthcare systems and ... expertise regarding products and the approved conditions they treat. Otsuka's Medical Science Liaison (MSL) will provide deep clinical expertise on-demand and… more
- CVS Health (Austin, TX)
- …and problem solve - Strong oral communication skills. Analyzes and approves routine claims that cannot be auto adjudicated. Applies medical necessity guidelines, ... Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. + Documents claim information in the… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Resolution team handles all complaints for Humana, including formal grievances, appeals, inquiries ... the overall experience for our associates, members and providers. As the Resolution Team Operations Director (Director, Grievance and Appeals), you will be… more
- Humana (Austin, TX)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Humana (Austin, TX)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more